CT-related parameters and Framingham score as predictors of spontaneous passage of ureteral stones ≤ 10 mm: results from a prospective, observational, multicenter study

Selvi, İsmail; Baydilli, Numan; Tokmak, Turgut Tursem; Akınsal, Emre Can; Başar, Halil

doi:10.1007/s00240-020-01214-6

Cited by 18 publications

(14 citation statements)

References 23 publications

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“… 17 , 18 , 22 Lastly, there is controversy in the literature regarding the role of ureteral diameter and the relation between ureteral and stone diameter in the prospect of SSP. 23 , 32 This study supports the idea that the increase in UWT and the dilatation of the urinary tract above the level of obstruction decrease the chance of SSP and promote EI.…”

Section: Discussionsupporting

confidence: 81%

“…However, a cardiovascular risk assessment score (Framingham score) was used recently to predict SSP, and it was shown that a higher score is associated with EI. 8,23 In this article, we described clinical and radiological features that may aid early recognition of patients suitable for EI, to allow prioritisation and fast-tracking to urology services for close monitoring and potential EI. Standard biochemical workup often entails slight variation in AUC cases, including CBC, kidney function test, and CRP.…”

Section: Discussionmentioning

confidence: 99%

“…30,31 We found that the extrarenal pelvis, AP diameter of the renal pelvis, and UWT are significantly associated with EI. A higher degree of renal pelvis distention represented by an AP diameter of 18 mm [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] is significantly associated with EI. The significance of the dilatation of the renal pelvis and the degree of hydronephrosis has previously been studied.…”

Section: Dovepressmentioning

confidence: 99%

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Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

Abushamma¹,

Ktaifan²,

Abdallah³

et al. 2021

IJGM

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Purpose Acute ureteric colic (AUC) is generally one of the most common reasons for emergency department attendance. Expectant management is recommended in non-complicated ureteral calculi. However, data regarding the optimal duration of observation or indications of early intervention (EI) are not well understood. This article describes the clinical and radiological factors that promote EI in AUC. Patients and Methods This was an observational and retrospective cohort study. Patients with AUC diagnosed based on non-contrast computerized tomography (NCCT) between 2019 and 2020 were enrolled in the study. These patients were classified into two main categories: spontaneous passage of stone (SSP) and EI. In addition, a comparative analysis was performed to identify clinical and radiological variables that promote EI. Results One-hundred and sixty-one patients were included. High WBCs are associated with a significant increase in EI. Forty-three percent (n=37) of patients with serum WBCs higher than 10 had an EI, while 23% had SSP (n=17; p <0.001). High CRP level is also significantly associated with EI (n=36; 86%; p <0.001). Upper and middle ureteral calculi are statistically associated with EI (n=54; 62%) in comparison to the SSP cohort (n=22; 30%; p <0.001). EI is also linked to the maximal length of ureteric calculi (MCL) of 9 mm (6–13mm), and HU density of stone of 700 (430–990) H.U ( p <0.001). Ureteric stone volume of 0.2 (0.06–0.3) cm 3 is significantly associated with EI ( p <0.001). Ureteral wall thickness of 3 (2–3 mm), the presence of extrarenal pelvis (n=20; 23%), and AP diameter of renal pelvis 18 (13–28 mm) are all significantly associated with a higher rate of EI ( p <0.001). Multiple binary logistic regression analysis showed that MCL is the strongest predictor of EI. Conclusion MCL is an independent and robust predictor of EI in AUC. Biochemical variables and radiological characteristics can also act as an adjunct to promote EI.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

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Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

Abushamma¹,

Ktaifan²,

Abdallah³

et al. 2021

IJGM

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show abstract

“…[ 23 ] Another study by Selvi et al ., hypothesized that higher Framingham score may be associated with noncalcium stones with higher stone volumes and functional impairment of ureteral peristalsis due to chronic inflammation in metabolic syndrome resulting in lower spontaneous stone passage rates. [ 24 ] In 1930, William Tillet first coined the term CRP, a protein that precipitated streptococcus pneumonia C-polysaccharide. Any inflammatory response stimulates synthesize of CRP from liver.…”

Section: Discussionmentioning

confidence: 99%

Role of inflammatory markers and their trends in predicting the outcome of medical expulsive therapy for distal ureteric calculus

et al. 2022

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Objective: Symptomatic ureteric stones cause surrounding inflammation-promoting obstruction. C-reactive protein (CRP), white blood cell count (WC), and neutrophil percentage (NP) tend to rise after inflammatory response. Monitoring response during the course of medical expulsive therapy (MET) may help in deciding early intervention, thereby decreasing morbidity. We assessed the role and trends of these markers in predicting the outcome of MET. Materials and Methods: One hundred and ninety-two patients with distal ureteric calculus of size >5 mm were included in this prospective study from April 2017 to March 2018 after ethical committee approval. CRP, NP, and WC were measured on day 1, 7, and 14 of MET, and analysis was done. Results: On univariate analysis, stone size and mean values of CRP, WC, and NP on day 1, 7 and 14 in stone nonpassers were significantly higher compared to stone passers ( P < 0.05). Receiver operator curve analysis showed area under the curve value of 0.798 ( P = 0.001) for CRP and cut off value determined was 1.35 mg/dL. Multivariate analysis of different variables showed significant association of higher CRP (>1.35 mg/dL) and larger stone size (>7 mm) with MET failure. Decreasing trend of CRP was seen in both groups, but values were higher in stone nonpassers. WC and NP showed decreasing trend in stone passers but persistently high in stone nonpassers. Conclusions: Higher CRP and larger stone size were associated with failure of MET. WC and NP showed decreasing trend in stone passers and persistently higher in nonpassers, which may potentially predict failure of MET, however, their role need to be further studied.

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“…Despite this progress, the success of UAS placement is difcult to predict preoperatively. Noncontrast-enhanced computed tomography (CT) can determine the stone size, proximal ureteral diameter, degree of hydronephrosis, and surrounding anatomy, experienced urologists can often judge the success rate of UAS placement from CT, and CT-based tools/ measurements were applied to identify key predictors of successful ureteral stone passage [8][9][10]. Tus, we were enlightened to develop a model for predicting the success of UAS placement based on CT. We hope to include as many parameters as possible for analysis.…”

Section: Introductionmentioning

confidence: 99%

CT-Based Predictor for the Success of 12/14-Fr Ureteral Access Sheath Placement

Liu

et al. 2022

International Journal of Clinical Practice

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Purpose. Ureteral access sheaths (UAS) are widely used in retrograde intrarenal surgery (RIRS), and this study aimed to develop a model for predicting the success of UAS placement based on computed tomography. Methods. We analyzed the clinical data of 847 patients who received ureteroscopy. Data on patient and stone characteristics and several computed tomography (CT)-based measurements were collected. A nomogram predicting the success of UAS placement was developed and validated using R software. Results. Two hundred and forty-seven patients were identified. Twenty-five patients (10.1%) failed to pass through the UAS. A model with three factors including the short diameter of ureteral calculi, the short diameter of hydronephrosis, and the diameter of the narrowest part of the renal parenchyma was to be strongly practical and had a high area under the curve on internal validation (80.3%). Using a threshold cutoff of 92%, the sensitivity and specificity for predicting UAS placement were 0.35 and 0.92, respectively. Conclusion. Our study provides a nomogram for predicting the success of UAS placement, and this model could help discriminate patients who are likely to suffer from failed UAS insertion; preoperative ureteral stenting is recommended according to the prediction.

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CT-related parameters and Framingham score as predictors of spontaneous passage of ureteral stones ≤ 10 mm: results from a prospective, observational, multicenter study

Cited by 18 publications

References 23 publications

Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

Role of inflammatory markers and their trends in predicting the outcome of medical expulsive therapy for distal ureteric calculus

CT-Based Predictor for the Success of 12/14-Fr Ureteral Access Sheath Placement

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